Blogs

12/19/2011

"I was so keen to hide [having bipolar disorder]. You just want to be normal... I just became morbidly aware of [feeling not normal] and sort of depressed."

"The only problem about seeing a psychiatrist is that what happens to you as a child is indelibly printed on your brain. You know, 'they fuck you up, your mum and dad'."
- Rick Stein

"You know, if you're down and you see a reason why you should be down, then that brings a certain clarity. But when there is no reason [to feel down] you tend to thing why on earth am I feeling like this?"
- Tony Slattery, Comedian and Actor

"Everything that happens is because you are a cunt. It’s because I’m a wanker, it’s because I’m an arsehole. You sort of have a Tourette view of yourself. You think about death all the time. Even if you’re not feeling suicidal, you’re just constantly aware of death and aware of your own death and how welcome it would be."
-Stephen Fry, Actor

"I so very much bitterly resent having depression... I resent it deeply."
(Responding to the question of why she tried to drill a hole in her head with an electric drill) "I was just so utterly despaired, and I didn't think I could take anymore."
- Connie, a sufferer from Birmingham.

"We have a long way to go 'till mental health is just accepted as part of everyday, you know, part of the rich tapestry of life."
- Liz Miller, Neurosurgeon

Other Documentaries:

Depression: Out Of The Shadows (the best video to see to find out more about depression)
No Kidding Me 2!
Men Get Depression
The Truth About Suicide (25-minute informational video)

12/05/2011

• Perhaps
the biggest solace was realizing and accepting that this horrible feeling is only
temporary and is the result of the disease, and that reality is not as
bad as I perceive it to be. Accepting this stopped me from trying to resist it,
which was vain and enervating, and helped me accept it. When the fog would come over me
and torment my mind, I learned to "lay low" and "wait out the storm"
by not trying to resist it. It is still difficult but takes less energy
than to vainly try to break free from it.
• One thing that
unfailingly makes me feel good when I feel hopeless and worthless, is
reminding myself that other people felt the same way or even worse,
thereby making it OK for me to feel this way. Like Abraham Lincoln,
despite having severe depression he went on to do great things. It
validates my feeling, and makes me feel like I'm not alone.
• The other solace is being able to relate to somebody else who was going through the same thing. It put things in perspective.
• Writing
about my feelings (blogging and journaling), listening to validating
music (I listened to Korn a lot), reading a validating book (like a
memoir)
• Also, “coming out” was a great relief. It was hard to
tell others, but telling friends took a huge burden off my shoulders of
keeping it a secret. Letting others know about my illness makes me
feel like I am breaking down the silence around it and that something
good has come out of my experience. Sharing with others that you have a
mental illness is difficult at first because you are vulnerable and
stigmatized, but I noticed that, as a rule, when I share something
personal others tend to share something about themselves. Also, it’s
surprising how many people want you to share your experiences because
they themselves are depressed. They are hoping that somebody will help
them but are just too afraid to say reach out.
• Meditation. I paid $375 (which was already a 50% student discount on
the full $750 fee) to learn transcendental meditation. The technique is
really simple and does not require much training; however, paying the
money made me commit to it more. The technique involves sitting still
for 20 minutes in the morning and at night and repeating a mantra in
your head--it can be anything, like "one" or "ohm"--while not thinking
about anything else, and if you catch your mind drifting, gently bring
it back to the mantra. Meditation is extremely effective at easing
anxiety and worry. However, it is really hard to get into the habit and
takes a few tries before you can calm your mind down effectively.
• Books. I
bought several self-help books and memoirs, which helped tremendously.
Reading memoirs helped me feel less alone and understand that what I
was experiencing was normal, and reading self-help helped me understand
what I was going through better and feel like I had some control over
my well being. The memoirs I read were: An Unquiet Mind, and Darkness
Visible. Recently I also read Lincoln's Melancholy, and Unholy Ghost. I
also bought The Feeling Good Handbook by David Burns, which has a lot
of helpful information and exercises. My therapist also recommended me
the Dialectical Behavior Therapy Skills Workbook to help manage my
emotions.
• Having goals that requires discipline. For me, this was to get my yellow belt in Judo, which required coming to practices twice a week. Also, I wanted to gain lean muscle mass, so I was going to the gym regularly. These fitness goals helped me tremendously in managing my mood and stress.

Other suggestions for how to get the most from depression treatment:

• Monitor your mood.
Monitoring your moods and behavior from time to time can help your
doctor treat your depression before it becomes hard to control. Try to observe any patterns of mood swings each week and call your doctor if you aren’t feeling at the top of your game.
• Strengthen your social support. While you cannot control your depression diagnosis, there are some things you can control. You can seek or create a positive support system for
yourself. Whether your social network stems from your spouse, family
members, close friends, co-workers, religious organizations, or
community groups, support is available.
• See a depression expert. Any doctor can prescribe depression medication, but a prescription alone isn't the best treatment. You should seek out an expert, like a psychiatrist or a psychologist.
Your condition is, by definition, hard to treat. It's important to talk
with a trained professional during your treatment. Although
psychologists cannot prescribe medication, they are well-trained in
psychotherapy. You can work with a psychologist while taking
antidepressants prescribed by your regular doctor, or you can see a
psychiatrist for both your depression medication and talk therapy. Try
to find someone who has a lot of experience helping people with
treatment-resistant depression.
• Develop good habits.Take
your depression medicine at the same time every day. It's easier to
remember if you do it along with another activity such as eating breakfast
or getting into bed. Get a weekly pillbox, which will make it easy to
see if you've missed a dose. Since people sometimes forget a dose now
and then, make sure you know what to do if that happens.
• Don't ignore side effects.
Side effects are one of the main reasons that people give up on
medication. For instance, in a British study of just over 1,000 people
with depression, 65% said they stopped taking their medicine at some
point. Of this group, about 45% said side effects were the reason. The
results were published in Current Medical Research and Opinion in 2003. If you have side effects, talk to your doctor.
See if there's any way to minimize or eliminate them. However, keep in
mind that side effects might be worse when you first start a medicine.
Side effects often ease up over time.
• Maintain regular sleep habits.Talk to your doctor if you have difficulty falling asleep or maintaining sleep.
There are new non-addictive medications available that can help resolve
sleep problems. Also, cognitive behavioral therapy has been shown in
recent clinical trials to be a helpful adjunct treatment for patients
who have impaired sleep efficiency, or anxiety and fears about poor
sleep.

Andrew Solomon's interview (author of The Noonday Demon):from documentary DEPRESSION: Out of the Shadows

What advice would you give others?

First piece of advice: Deal with it early. Don't wait until it
escalates out of control. Like any illness, it's easier to treat before
it becomes acute.

Second piece of advice: Find the right therapist and
psychopharmacologist. Sometimes that's one person and sometimes it's two
people; seek the best. There a lot of bad treatments and too many
incompetent shrinks, so if you're not getting better, try seeing someone
else. It's exhausting and annoying shopping around, but as in all other
areas of life, there are some people who are highly skilled and others
who just aren't very good. There are also people who work well for one
patient and aren't right for another.

Third piece of advice: If you have a chronic condition, treat it in
the long-term. Have the courage to stay on your meds, and don't be
tricked into thinking that brave people get better on their own. If you
had lung cancer, you wouldn't try to cure it by breathing carefully.
Don't trivialize depression. Remember that it can be fatal: A large
number of depressed people commit suicide.

Fourth piece of advice: Don't keep it all a big secret. Depression is stressful and keeping secrets is stressful. But tell people selectively and carefully. Some people can deal with it and others can't. And get yourself a support structure. Love won't cure depression, but it will make it a whole lot easier to tolerate.

Many people I know, and even I used to resist taking any kind of medication. This is especially true with prescription medication and those that affect mood, such as antidepressants. Looking back at the reasons I gave against taking antidepressants I realized that most of them were irrational and were based on irrational, culturally constructed beliefs. Through talking to people and personal experience, I devised a list of the most common reasons people give for- and against taking antidepressants.

Reasons People Give Against Taking Antidepressants

• Shortcut, does not involve work. Like plastic surgery
• Not a “natural” solution
• Involves changing something in you. Feel uncomfortable because the better "you" isn’t actually you
• Fear of changes in personality
• Temporary solution
• Fear of dependency and getting addicted (possibly on other drugs as well)
• Fear of having to take it for the rest of your life
• Possible side effects, e.g., nausea, insomnia, sexual dysfunction
• Possible withdrawal effects (under 20% of cases)
• Possible tolerance development (in about 20% or case, antidepressants loose effectiveness)
• Distrust of the pharmaceutical industry
• Cost (can be anywhere from 5 to 100 dollars a month)
• If you stop you can relapse into the illness
• Stigma of taking prescription medication
• Don't want to admit that there is something wrong with you (that you are sick and it’s not under your control) rather than a lifestyle choice.

Reasons For Taking Antidepressants

• If the depression is severe, antidepressants are most effective (scientifically proven)
• A last resort, if alternative remedies have not worked
• Many potential benefits, such as the possibility of complete remission (no more depression)
• Changes in personality
– Greater self-confidence and less anxiety
– Greater resilience in the face of set-backs
– More joy
– Positive changes in careers and relationships

Having major a.k.a. clinical depression is having a disease. And like any other disease, such as cancer or diabetes, you cannot cure yourself with your mind by simply being optimistic and "strong". Treatment can take months and sometimes years, with very gradual improvements. There is usually no single cause to depression, and it is wrong, ignorant, hurtful, and unhelpful to ask people with depression "why are you depressed", act like you know what is causing their depression, or tell them to simply "be happy". It is necessary to accept that there is nothing you can do to help a person with depression other than maybe keep him company.

The Myth: Mental illnesses are all in your head, and you can just get over them if you really want to.

This earned the number one spot, not only because it’s general, but
because it’s probably the most damaging myth about mental illness, since it prevents the acceptance of depression as a real disease. Some people still
believe that mental illnesses are all imagined by their sufferers, or
that people who suffer from mental illness can’t really be having that
much trouble or just don’t care enough about getting over it. People
are especially likely to be dismissive if they don't know much about the illness.

The fact that the same symptoms have been experienced by so many
different people should prove that they are real — they can’t all be
independently inventing the same symptoms. Any mental disorder, by
definition, seriously affects the lives of the people who suffer from
it, usually for the worse, or it would not be considered a disorder. And
they are certainly not easy to get over. Most mental disorders are
caused at least in part by a difference in the brain or an imbalance of
chemicals. Even when it comes to the non-physical reasons, it’s very
difficult to un-learn a thought pattern or habit — just choose any habit
and try it. Plus, the disorder itself may stop someone from trying to
get help: people with depression might think no therapist will be able
to help them, and be too tired to try to find one, anyway. If we could
overcome mental illnesses just by wanting to, the world would be full of
much happier and more productive people.

There is also the belief that if something bad happened to you than
you deserve it. The need to see victims as the recipients of their just
deserts can be
explained by what psychologists call the Just World Hypothesis, a cognitive bias.
According to the hypothesis, people have a strong desire or need to
believe that the world is an orderly, predictable, and just place, where
people get what they deserve. It's the belief that the wrong-doers will
always be punished and good-doers will always be rewarded. This belief
leads to the conclusion that victims of misfortune deserve what happens
to them. So those with afflictions are seen as at fault, whereas none is
due. You
wouldn't blame a cancer patient for getting cancer, nor should you a
depression patient. Sure, some of the cancer patient's life choices (bad
diet, lack of exercise) contributed to him getting cancer, but we don't
blame him for getting it. This belief also leads to other terrible
conclusions, such as that rape victims and victims of child abuse are
somehow responsible for their misfortune. There are other, more subtle
beliefs that stem from the Just World Theory, such as that poor people
are wicked and rich people are righteous. This idea comes from the
Bible, which says that if you commit a sin, several generations will pay
for it. It's also present in some eastern thought, as "karma", or
everything bad that happens to you is punishment for something you did
in your past life. Such a belief plays an important function in our
lives since in order to plan our lives or achieve our goals we need to
assume that our actions will have predictable consequences. Moreover,
when we encounter evidence suggesting that the world is not just, we
quickly act to restore justice by helping the victim or we persuade
ourselves that no injustice has occurred. We either lend assistance or
we decide that the rape victim must have asked for it, the homeless
person is simply lazy, the fallen star must be an adulterer. These
attitudes are continually reinforced in the ubiquitous fairy tales,
fables, comic books, cop shows and other morality tales of our culture,
in which good is always rewarded and evil punished.

The Fallacy of Control

This belief that you can always control how you feel probably
stems from Americans' overly individualistic view of the world. We
believe that we alone are responsible for our fortune and misfortune.
This is actually very rarely true. In real life, there are many things
(such as our emotions) that are out of our immediate control, and most
of the time the perception of control is an illusion. This is especially
true for people with depression, who cannot cure their depression with
their minds anymore than a person with cancer can cure his cancer. Even
thought the majority (80 percent) of people with depression eventually
(in six months on average) recover (due to mostly unknown reasons), a
minority (20 percent) has what is called treatment-resistant depression,
which does not respond to treatment. If you are one of a few people who
are unemployed in a nation, it's probably your responsibility, but if
you are one among the 10% of the nation's unemployed, this isn't a
personal problem anymore but a social problem. However, when we see an
individual who is unemployed, we discount all the social forces that
caused him to be unemployed and assume that he is just lazy or unwilling
to find work.

The Mind-Body Separation

What I've noticed is that people are much more reluctant to accept the existence
of mental illnesses then physical ones. This reluctance has the effect
of preventing insurance parity (equal treatment) between physical and
mental problems. One person I know is OK with taking fat burning pills that contain the supplement 5-HTP (an appetite suppressant and mood enhancer), but he is not OK with taking 5-HTP by itself.

11/30/2011

I am convinced that stoicism is never the answer to anything, being nothing more than a cruel, callous encouragement to people to devour each other, a powerful ally of sadists and tyrants keen to get people to endure things which should be firmly refused as unendurable. Courage, indeed!

--Les Murray, Killing the Black Dog

There is more stigma for men to seek help with depression. The biggest obstacle for men to reach out for help is our own pride. As guys we like to think that we don't need any help and that we'll manage just fine on our own. Whenever we consider getting help we think, "getting help would be admitting to myself and to others that I am in a really bad shape, and they may laugh at me; it's better if I just wait it out", and "oh man, seeing a therapist must mean that I'm too weak to resolve my problems on my own". But the truth is, men have feelings and aren't immune to psychological trauma. Men do get depression. Getting depression does not take away from a man's masculinity or make him weak. Real men get depression. Depression is a real illness like diabetes, cancer, or heard disease; it is treatable; and men can have
it. It takes courage to ask for help, but help can make all the
difference.

Symptoms of major depression (1-9 are from DSM-IV):

Persistent sad, anxious, or "empty" mood

Loss of interest or pleasure in hobbies and activities that were once enjoyed, including food and sex

Feelings of hopelessness, pessimism

Feelings of excessive guilt, worthlessness, helplessness

Decreased energy, fatigue, being "slowed down"

Difficulty concentrating, remembering, making decisions

Trouble sleeping, early-morning awakening, or oversleeping

Appetite changes or weight changes

Thoughts of death or suicide, or suicide attempts

Restlessness, irritability, anger

Persistent physical symptoms, such as headaches, digestive disorders, and chronic pain, which do not respond to routine treatment

Some themes and symptoms from the documentary "Men Get Depression"

Isolation.

Eating a lot.

Worthlessness. Feeling different from everybody else, like you are weird, incompetent, and even subhuman.

Forgetting what it is like to feel "normal".

Rage, breaking things.

Hard to get out of bed.

Feeling extremely "down". Pain seems bottomless.

Putting up a front to meet others' expectations of who you should be.

Affects all aspects of your life: relationships, school, and work.

Thoughts are out of control. "Wheels are spinning."

Offers to help (such as, "I think you should see a therapist") are taken as criticism.

Loved ones are "walking on eggshells" for fear of triggering a feat of rage or hurting your feelings.

Impulsive and risky behavior, thrill-seeking.

A sense that it's something that can be brushed away, because you can't see it. A sense that there is a single cause, and if I could just find what it is, this weight would go away.

Difficulty of accepting that it's something more, that it won't go away easily, and that you have no control over it, and that it is a real disease.

Normalizing depression: believing that it is the normal way to feel, and that the feelings are the natural response to life's stressors. "It's just how life is... It seems like it's never going to end, things aren't going to get better." However, thinking about depression as an illness is powerful because it gives hope that things could be changed.

"I feel uncomfortable talking about it because it means you are weak."

"Nobody picked up on the signs I exhibited. I wish somebody did, because it would show that somebody cared about me."

Problems and emotions seem unmanageable.

The positive that came out of it was: gaining new coping skills, having pride in overcoming the biggest adversity in the human experience, knowing your abilities and your limits, recognizing signs of an upcoming episode to prevent a relapse.

Some men who have had depression:

William Styron, writer and author of Darkness Visible: A Memoir of Depression"[Depression is] despair beyond despair... In depression this faith in deliverance,
in ultimate restoration, is absent. The pain is unrelenting, and what
makes the condition intolerable is the foreknowledge that no remedy
will come- not in a day, an hour, a month, or a minute... In
virtually any other serious sickness, a patient who felt similar
devastation would by lying flat in bed, possibly sedated and hooked up
to the tubes and wires of life-support systems, but at the very least
in a posture of repose and in an isolated setting. His invalidism would
be necessary, unquestioned and honorably attained. However, the
sufferer from depression has no such option."

Andrew Solomon, writer and author of Noonday Demon: An Atlas of Depression"The opposite of depression is not happiness, but vitality, and it was
vitality that seemed to seep out of me. I remember particularly that I
would come home, and I would listen to the messages on my answering
machine, and instead of being pleased to hear from my friends, I would
feel tired, and think, that's an awful lot of people to have to call
back."

Drew Carey, Comedian, host of "Who's Line Is It Anyway?" and "The Price Is Right"

"I was depressed for a long time... I remember going to a frat party, and everybody was having a good time, and laughing and meeting girls. And I﻿ was just 'why are they having a good time, what do they got to be happy about?' I just couldn't understand why I was so miserable. Back then I was so full of a lot of self-hate... I [thought I] wasn't as good as they were, I wasn't as worthy as they are. And all that stuff makes you just hate yourself and judge yourself."

Abraham Lincoln, President of the United States of America

"I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth. Whether I shall ever be better I can not tell; I awfully forebode I shall not. To remain as I am is impossible; I must die or be better, it appears to me."